Forensic Psychiatric Hospital to improve staff safety

19/09/2018

Vancouver – The Forensic Psychiatric Hospital is rolling out significant changes, including increased staffing, expanded security, and specialized training, which will make immediate improvements to protect staff.

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The 190-bed hospital, located in Coquitlam, B.C., treats patients with serious and complex mental-health challenges who have been found not criminally responsible for a crime or unfit to stand trial.

Hospital leadership and the BC Nurses’ Union and the BC Government and Service Employees’ Union have discussed the implementation of these changes, which will be effective immediately:

Improvements to security teams. This will include increased presence of security guards. Two security officers will be dedicated 24-7 to the hospital’s four high-security units. Security staff will receive specialized training to ensure they have expertise in forensic health and to lessen patient anxiety. The roles and responsibilities of security guards will be reviewed so that security can better support clinical staff. The unions and hospital leadership will be jointly seeking to reinstate “special constable” status for the forensic security officers to give them more authority when needed in an emergency.

Establishment of new teams of specialized clinical-security liaisons. A first in B.C., these health-care professionals, who specialize in safety at secure hospitals, will be stationed in high-security units, teaching staff to be acutely aware of their surroundings and build a deep rapport with and understanding of their patients, so they are able to anticipate, de-escalate and prevent aggression.

Expanded orientation and training in relational security and emergency response for all staff. We will implement therapeutic and relational security training for all clinical staff. In addition, mock-response scenarios will be conducted regularly so that each staff member can practice emergency procedures.

Increased 24/7 supervision and leadership. Clinical nurse leaders will now dedicate 100 per cent of their time to leadership, supervision, practice improvements and ongoing training and development of staff. In addition, an evening and weekend nursing shift manager position will be created to increase evening and weekend supervision and clinical support.

Enhanced staffing support for better patient care: Additional staff will be hired to provide better care for each patient on the units.

A commitment to participate in an evaluation of these safety measures – in particular enhanced security, before and after implementation.

“We take the physical and psychological safety of our employees very seriously and are deeply troubled when any of them experience a workplace assault,” said Carl Roy, the CEO of the Provincial Health Services Authority, which oversees the hospital. “We have an incredibly compassionate and skilled labour force that provides high-quality care to a high-needs population in challenging working conditions. We must do everything we can to improve staff safety and ensure our employees have effective training and security measures in place. Patient care is also improved when the working environment is safe for all.”

The improvements are part of an action plan that was completed after an extensive external review with a team of international forensics experts. The review included feedback from staff, patients and partners, including the BC Nurses’ Union (BCNU) and the BC Government and Service Employees’ Union (BCGEU).

“The BCGEU has repeatedly raised concerns about the safety of our members at Forensics Psychiatric Hospital over the last number of years,” said Stephanie Smith, president of the BC Government and Service Employees’ Union. “We are pleased to see the PHSA taking those concerns seriously and we look forward to doing our part to create a safe, healthy workplace for our members.”

“Nurses have been raising safety concerns at Forensics for many years. I am pleased that PHSA is now making the necessary changes to reduce the risk of workplace violence faced by nurses. I look forward to ongoing collaboration on future initiatives by PHSA to enhance the delivery of safe patient care,” said Christine Sorensen, the president of the BC Nurses’ Union.

“Our patients have very complex mental-health challenges and we are fortunate to have staff who are dedicated to working with this community,” said Lynn Pelletier, the vice president of BC Mental Health and Substance Use Services. “Working at the Forensic Psychiatric Hospital requires staff with specialized training in assessing risk, and preventing and responding to aggression in ways that protect both the staff and the patients."

“We have made good progress by working collaboratively with employees over the last several months, and I'm confident by continuing to work with our staff to implement these immediate changes, together we can make a significant difference in creating a safer environment,” Pelletier said.

The changes will build on the safety measures we currently have in place, including the Provincial Violence Prevention Curriculum, duress systems that allow health-care staff to page a security guard for immediate assistance, restraints and seclusion rooms, and specialized protocols and procedures in the case of an emergency caused by patient aggression.

Learn more

BC Mental Health & Substance Use Services (BCMHSUS), part of the Provincial Health Services Authority (PHSA), provides a diverse range of specialized and one-of-a-kind tertiary mental health and substance use services across the province. Our overarching goal is to work with the regional health authorities and other key stakeholders to ensure that everyone in B.C. has access to the specialized mental health services they need, when they need them, regardless of where they live.

In addition to delivering clinical services, BCMHSUS provides provincial leadership for system-wide improvement through its work in health promotion and illness prevention; knowledge exchange; and research and academic teaching. Recognizing that people with mental health challenges may also have co-occurring substance use concerns, the assessment and treatment of substance use issues is an integral part of our programs.

PHSA plans, manages and evaluates selected specialty and province-wide health care services across B.C., working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us on Twitter @PHSAofBC.